The modern reverse shoulder arthroplasty and an updated systematic review for each complication: part I

Sarav S. Shah, MD; Benjamin T. Gaal, BA; Alexander M. Roche, BA; Surena Namdari, MD; Brian M. Grawe, MD; Macy Lawler, BS; Stewart Dalton, MD; Joseph J. King, MD; Joshua Helmkamp, BS; Grant E. Garrigues, MD; Thomas W. Wright, MD; Bradley S. Schoch, MD; Kyle Flik, MD; Randall J. Otto, MD; Richard Jones, MD; Andrew Jawa, MD; Peter McCann, MD; Joseph Abboud, MD; Gabe Horneff, MD; Glen Ross, MD; Richard Friedman, MD; Eric T. Ricchetti, MD; Douglas Boardman, MD; Robert Z. Tashjian, MD; Lawrence V. Gulotta, MD

JSES International (Dec 2020)

The modern reverse shoulder arthroplasty and an updated systematic review for each complication: part I

Sarav S. Shah, MD,
Benjamin T. Gaal, BA,
Alexander M. Roche, BA,
Surena Namdari, MD,
Brian M. Grawe, MD,
Macy Lawler, BS,
Stewart Dalton, MD,
Joseph J. King, MD,
Joshua Helmkamp, BS,
Grant E. Garrigues, MD,
Thomas W. Wright, MD,
Bradley S. Schoch, MD,
Kyle Flik, MD,
Randall J. Otto, MD,
Richard Jones, MD,
Andrew Jawa, MD,
Peter McCann, MD,
Joseph Abboud, MD,
Gabe Horneff, MD,
Glen Ross, MD,
Richard Friedman, MD,
Eric T. Ricchetti, MD,
Douglas Boardman, MD,
Robert Z. Tashjian, MD,
Lawrence V. Gulotta, MD

Affiliations

Sarav S. Shah, MD: Corresponding author: Sarav S. Shah, MD, American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications“ 9400 W Higgins Rd, Rosemont, IL 60018, USA.; American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Benjamin T. Gaal, BA: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Alexander M. Roche, BA: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Surena Namdari, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Brian M. Grawe, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Macy Lawler, BS: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Stewart Dalton, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Joseph J. King, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Joshua Helmkamp, BS: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Grant E. Garrigues, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Thomas W. Wright, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Bradley S. Schoch, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Kyle Flik, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Randall J. Otto, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Richard Jones, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Andrew Jawa, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Peter McCann, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Joseph Abboud, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Gabe Horneff, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Glen Ross, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Richard Friedman, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Eric T. Ricchetti, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Douglas Boardman, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Robert Z. Tashjian, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA
Lawrence V. Gulotta, MD: American Shoulder and Elbow Surgeons Multicenter Task Force on Reverse Total Shoulder Arthroplasty Complications, Rosemont, IL, USA

Journal volume & issue: Vol. 4, no. 4
pp. 929 – 943

Abstract

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Background: Globally, reverse shoulder arthroplasty (RSA) has moved away from the Grammont design to modern prosthesis designs. The purpose of this 2-part study was to systematically review each of the most common complications of RSA, limiting each search to publications in 2010 or later. In this part (part I), we examined (1) scapular notching (SN), (2) periprosthetic infection (PJI), (3) mechanical failure (glenoid or humeral component), and (4) neurologic injury (NI). Methods: Four separate PubMed database searches were performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Overall, 113 studies on SN, 62 on PJI, 34 on mechanical failure, and 48 on NI were included in our reviews. Univariate analysis was performed with the χ2 or Fisher exact test. Results: The Grammont design had a higher SN rate vs. all other designs combined (42.5% vs. 12.3%, P < .001). The onlay humeral design had a lower rate than the lateralized glenoid design (10.5% vs. 14.8%, P < .001). The PJI rate was 2.4% for primary RSA and 2.6% for revision RSA. The incidence of glenoid and humeral component loosening was 2.3% and 1.4%, respectively. The Grammont design had an increased NI rate vs. all other designs combined (0.9% vs. 0.1%, P = .04). Conclusions: Focused systematic reviews of the recent literature with a large volume of RSAs demonstrate that with the use of non-Grammont modern prosthesis designs, complications including SN, PJI, glenoid component loosening, and NI are significantly reduced compared with previous studies. As the indications for RSA continue to expand, it is imperative to accurately track the rates and types of complications to justify its cost and increased indications.

Published in JSES International

ISSN: 2666-6383 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery; Medicine: Internal medicine: Specialties of internal medicine: Diseases of the musculoskeletal system
Website: https://www.journals.elsevier.com/jses-international

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